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Home My WebLink About23819-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25012 Date MAY 6, 1997 THIS CERTIFIES that the buildin~ Location of Propert~ 1975 CEDAR DRIVE House No. County Tax Map NO. 1000 Section 77 Subdivision ADDITION & ALTERATION SOUTHOLD, N.Y. Block 1 Filed Map No. Street Lot 26 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 7, 1996 pursuant to which Building Permit No. 23819-Z dated NOVEMBER 23, ~996 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION & ALTERATION TO EXISTING ACCESSORY STORAGE SHED AS APPLIED FOR. The certificate is issued to BRIAN & CATHY CAMPBELL (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 TOWN OF $OUTHOLD BUILDII~IG DEPARTJ~EHT TOWH HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 23819 Z Permission is hereby granted to: , __ . punuont to application dot~ ...... ~ .................................... , 19.~., and opprov~ by the Building Inspector. / Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Blanning Board Approval of c6mpleted site plan requirements. For existing buildings (prior to April 9~ 1957) non-conforming uses, or buildings and ?pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, ~~y build~ Businesses $50.00. 2. Ger~z~lca~e ox trc~lllp~z~cy on~P~-e-existinR Buildin~ - $100.00 3. Copy of Certificate of Occupancy - ~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Cormnercial $15.00 Date .~.~C~..~..~.,.~ ~ ~ ~ ................ House No. Street Ha~et ............ .. .. .. . County T~ ~p No 1000, Section ............. Block ..... ~ ......... Lot .................. Subdivision Filed Map Lot · · Permit No..~.~.~/.~..]~..Date Of Permit ........... .. ...Applicant.. ........................ . . . Health Dept Approval Underwriters Approval ........ Planning Board Approval ........................ Request for: Fee Submitted: Temporary Certificate ...... ... . . Final Carticate ..... ... ... Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD March 25, 1997 Brian H. & Cathy Campbell 1975 Cedar Drive Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 23819-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ~IELD INSPECTION REPORT DATE ......................... ~__N~__~ .................. ~OUNDATION (IST) ~OUNDATI ON (2_Nq2__) '~ ~' ROUG~ FRAME & PLUM]SING %NSULATION PER N. STATE ENERGY CODE ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING []FIREPLACE&CHIMNEY REMARKS: ~/'~ ~ ~, ~' [ ] ROUGH PLBG. [ ] I~ISULATION [ ~FINAL ~/~./~-/) DATE FOIR'INO. TO~N OF SOUTHOIJ) BUILDING DEPARTHENT TOWN HALL SOUTBOI~, N.Y. 11971 TEL: 765-1802 DisapDroved a/c .................................. / (B~i~ng I~pactor) BOARD OF llEtd,T|! ............... 3 SETS OF PI,ANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORH ................... NOTIFY: CALL . NAIl. TO: .................... APPLICATION FOR BUILDING PERHIT Date ................ · 19 .... INSTRUCTIONS i a. This application mist be ccmpletely filled in by typewriter or in ink and st~itted to tile hdldlng Inspector with ~ sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan ahc~ing lacatian of lot and of buildings on premises, relationship to adjoining premises or pablic streets or areas· and giving a detailed deseriptian of layout of property oust be dra~n on the diagran dnich is part of this application. e. The work covered by this applicatioh my not be coeaaeneed before issuance of Buitding Peusit. d. Upon approval of this application· the Building Inspector will issue a Building Penait to the ,applicant. Such permit shall be kept an the premises availshle for ioapeetion throughout the x~ork. e. RO tafilding ~hall be occupied or used in ~laole or in part for any purpose ~0hatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICAT[O~ IS IEi~iBY ~IAI~ to the Building Department for file issuance of a lkdlding Pemlt purmmnt to the Building Zone. Ordinance of the Tc~m of Southold, Suffolk Coonty, Ne~ York, and other applicable La~s, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for roroval or deaolitian, as herein described. '11~ applicant agrees to ccn~ly with all applleable l~ras, ordinances, building cede, housing code, and regulatians, and to acinit authorized inspectors on premises and in building for necessary inspeetlons. State dnether applicant is o~aer, lessee, agent, ardfitect, engineer, general contractor· electrician, plt~ber or huilder. .......... ro~.,~.~.:.<.. ....... . ~ Z'"'"' \'"'"i'd'"'""'"'_".'"" 7' 7'"'L3'"'"':"'"'/'IX,'"]'i""'"'"'" [as an the tax roll or latest deed) / Il: applicant is a corlx)ratlon, siDmture of duly antt~riz~d officer. (Nam and title of corporate officer) lklilders Licetme No .......................... Plmbers Liconse Ro. ........................ Electricians License Ro ...................... Other Traders License No ..................... I. location of land on ~l~idl propesed ~ork will be d~e .............................................................. .... .... ..... b ............................. ltonae l~mt)er Street ..q-1 El k ..... 0..) ...... .... Ce~lty Tax Hap No. 10(g) Section ...' -- Subdivision ...................................... Filed Hal) K) ................ I~t ............... (~e) 2. State existing uae and ocoapanc~ of pr~nises aed inteeded use a~gl occupancy of proposed constnmtion: a. ~isting ,~ ,,~ on~,~,~ ..... ~..~.---~...,.+,-~ ~- ..................................... ,~7~"~~ ~'~:.~'.. ............................. b. Intended use aed oconpmmy I0. II. 12. 13. 14. 15. rrm property li~s, G|ve street at, Ii block ,,~wAl~er interior or corner ]o1:, NzltHre Of ,ffo[k (c|w~:k ~hieh afl licable) Nc4o Ikfilding .......... ~klition ...~ .... Alteral:ioa .......... l~lmir l~al ~ 1~1 ilion ..... Other ~rk (l~ripti~O Est imt~l C~sl: ....... ~. .. f~ .............................................. (to Im ~aid on filing this al~ticatiaO 1E ¢~1 ling, ~M~f~r of (~11 'rog ' unltn ............................ raider oF (~lllng tmJlm (~t each flor 1~ garage, ~ami~r of earn ..... ~ ................................. If la,ai~eas, t~.~rcml or null ~tnqmtmy, a~clfy ~mture mxl extent of each ty~ of use ...................... Di.ensltms of existing atn~tures, if any: Fr¢mt ...... ~. ....... ~ar .... .~ ........ l~pth .... .~. ......... ................. ~]tmr of 8kerien ....... ~ .............. D,ner,sl.,s of.(q~sam stn<aire mlth alteratl,msl.~or ,~khkmn.: front ..:.. ....... ...... ~i~O,~ ....... ........ a,,~. or s~o... .... ]1] ........ · ·" I)memn~m of entire ~ c~mtr~mtlcm: F~d: ...... I..~ ...... ~ar . ..... ~i~O,t. ..... .... ..... ... a,i~ ,,:~ Sto~,~,' ........ ~ ............ Size of lot: F~t ..................../~ l~ar ..... [.~.0. ......... - ~pth . ................ ~,~ or n,~{,,~ .............. i ....... ~,~ o~ ,o,~ m~ ..C~.~... ~..~5~2 ..... ~.~ 7xam or nm di~trlct in sddeh ' situat~l .................................. ~ms prol~s~l c~amtnmtitm violnte any r~dng 1~, onlimt~e or regulatim: ........................ ~ill lot Im regr~l ........ ~......,,.0 Will excess fill Im rmm~ rran ~l~ off Arcltltect ......... , ........................... &klreos .............................. tine ~> ............... ~me oF C~lkractor ............ . ....................... &klress ............................... II~o~e K~ ............... fa I is p~rty within ~1 f~'t of a tidal xm la,l? * ~kq ~ ...~ ..... PI,OT DIM;RAH ltx:ate clem'ly m~ dlstlmtly a)l ladldi~s, Omt:lmr exist:leg or pro~>~l, m~l itxllcate all set-I~k dimensions t~$1$r or ¢~seripti~l according to Ck~l, aM ~x~ street n,ms ar~l imlieate -- · ..Imlng duly ~7ot'n~ delx)Ses taxi nays chat l)e in the ~qq)l icnat (C~mtractor, ni;eal:~ qorlx~rate of fleer, alq~l ienti¢m; that nil stat~mnts cCmtqu~l ia this alq~l teal i(.t are trim to the Imst of his k~xml~lge that the ~n'k witl I~ l~rfonmd in thq tmmmr ~t /'orth D~ the nlqfl ical:irm fil~l tlmr~lLh. CLAIRE L GLEW i Notary Public· State of NeW York No. 4879505 Qualified in Suffo k County Commission Expires December 8, 19c7.